Joint Products for Horses: Follow Directions for Safety

Veterinarians have the privilege of using medications “off-label” in certain situations to benefit the health and longevity of their patients. Pergolide serves as a classic example of off-label drug use in horses. This drug is borrowed from human medicine for the treatment of Cushing’s disease (pituitary pars intermedia dysfunction, PPID) in horses. Off-label drug use comes with great responsibility.

The perils of off-label drug use were recently highlighted in a study by the Colorado State University Gail Homes Equine Orthopedic Research Center¹. According to the researchers, using a non-FDA-approved joint product off-label not only appears to have no benefit but may also actually be harmful. The tested product contained ingredients typically included in oral joint supplements: hyaluronan, sodium chondroitin sulfate, and N-acetyl-D-glucosamine.

Based on a survey the researchers previously conducted², some equine veterinarians indicated they administer the joint product not as a joint lavage (intraarticularly) as indicated on the product label but instead intravenously (IV) or intramuscularly.

To determine if IV use of this product is beneficial for preventing or managing osteoarthritis (OA), Frisbie and coworkers administered the product to horses IV either prophylactically every 5 days before OA was induced or as a treatment for joint disease starting 16 days after onset of clinically induced OA.

“Joint disease, especially osteoarthritis, is a leading cause of attrition in horses and results in substantial economic losses within the industry. This is why veterinarians try off-label medications when treating patients with joint disease,” noted Kathleen Crandell, Ph.D., an equine nutritionist for Kentucky Equine Research (KER).

“The key finding of the study was that IV administration of this product as a preventative of OA either had no benefit or had adverse outcomes,” explained Crandell. “However, the previous study by these authors had shown benefit of intraarticular administration of the same product, which is how the product is marketed.”

The authors of the study cautioned, “It also should be pointed out that the experimental model of osteoarthritis used in the present study did not represent all degrees of osteoarthritis severity in clinically affected horses, and this should be considered in the interpretation of the results.”

Nonetheless, veterinarians remain reliant on tried-and-true methods of managing OA, including oral joint health supplements. Even these products, however, must be treated with respect considering that nutritional supplements are simply classified as “generally recognized as safe,” meaning the FDA and associated experts deemed those food additives safe for widespread consumption.

While this technical definition “generally” makes sense, because most ingredients are provided in small quantities in the overall diet and are derived from so-called natural sources, such as plants, significant interactions exist between certain ingredients and other elements in a diet³.

Always choose a quality joint supplement produced by a reputable manufacturer. Such products are more likely to contain the type and amount of ingredient listed on the label and be made using appropriate quality-assurance strategies like human pharmaceutical drugs. KER offers several products to support joint health in horses, including KER•Flex, Synovate HA, and EO•3, an omega-3 product.

Horse owners in Australia can find research-proven products here.

1 Frisbie, D.D., C.W. McIlwraith, C.E. Kawcak, et al. 2016. Efficacy of intravenous administration of hyaluronan, sodium, chondroitin sulfate, and N-acetyl-D-glucosamine for prevention or treatment of osteoarthritis in horses. American Journal of Veterinary Research. 77:1064-1070.

2 Ferris, D.J., D.D. Frisbie, C.W. McIlwraith CW, et al. 2011. Current joint therapy usage in equine practice: A survey of veterinarians 2009. Equine Veterinary Journal. 43(5):530-535.

3 Stargrove, M.B., J. Treasures, D.L. McKee. 2007. Herb, Nutrient, and Drug Interactions: Clinical Implications and Therapeutic Strategies. Mosby.